Provider Demographics
NPI:1316248123
Name:CHIRO-MED CARE OF GEORGIA PC
Entity type:Organization
Organization Name:CHIRO-MED CARE OF GEORGIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:H
Authorized Official - Last Name:ROWLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-254-6467
Mailing Address - Street 1:PO BOX 1426
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31040-1426
Mailing Address - Country:US
Mailing Address - Phone:478-254-6467
Mailing Address - Fax:478-254-6497
Practice Address - Street 1:1818 FORSYTH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-1183
Practice Address - Country:US
Practice Address - Phone:478-254-6467
Practice Address - Fax:478-254-6497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR002977111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACHIR002977OtherLICENSE
GA1467536110OtherNPI INDIVIDUAL